Hostname: page-component-848d4c4894-xfwgj Total loading time: 0 Render date: 2024-06-28T06:44:39.292Z Has data issue: false hasContentIssue false
  • English
  • Français

The epidemiology of good nutritional status among children from a population with a high prevalence of malnutrition

Published online by Cambridge University Press:  02 January 2007

Jane A Pryer ,
Stephen Rogers  and
Ataur Rahman
Jane A Pryer*
Affiliation:
Royal Free and University College London Medical School, University College London, Department of Primary Care and Population Sciences, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK International Food Policy Research Institute, Food and Nutrition Division, 2033 K Street, Washington, DC 20006-1002, USA
Stephen Rogers
Affiliation:
Royal Free and University College London Medical School, University College London, Department of Primary Care and Population Sciences, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
Ataur Rahman
Affiliation:
Proshika, I/1–GA, Section 2, Mirpur, Dhaka 1216, Bangladesh
*
*Corresponding author: Email j.pryer@pcps.ucl.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

To identify socio-economic demographic and environmental factors that predict better height-for-age for children under 5 years of age in a Dhaka slum population.

Design:

A panel survey, conducted between 1995 and 1997. A random sample of households was selected. Socio-economic, demographic and environmental variables were collected monthly by questionnaire and nutritional status was assessed.

Setting:

Dhaka slums in Bangladesh.

Subjects:

Three hundred and ninety-two children, surveyed in September–November 1996.

Main outcome measures:

Height-for-age Z-score (HAZ) above −2.

Results:

Thirty-one per cent of children had HAZ <−2. Logistic regression adjusted for cluster sampling showed that better nourished children were more likely to have taller mothers, to be from female-headed households and from families with higher income, electricity in the home, better latrines, more floor space and living in Central Mohammadpur. Better nourished children were less likely to have fathers who have taken days off from work due to illness.

Conclusions:

Interest in ‘positive deviance’ is motivated by the recognition that a focus on the malnourished only – the bottom tail of the distribution – provides indications of how families fail, but not of how they succeed in maintaining child nutrition in the face of adversity. Our analysis provides an alternative perspective on nutrition and vulnerability in an urban slum setting.

Keywords

MalnutitionSocio-economic statusDemographic statusPositive deviance
Type
Research Article
Information
Public Health Nutrition , Volume 7 , Issue 2 , April 2004 , pp. 311 - 317
Copyright
Copyright © CAB International 2004

References

1Zeitlin, M. Nutritional resilience in a hostile environment: positive deviance in child nutrition. Nutrition Reviews 1991; 49(9): 259–68.CrossRefGoogle Scholar
2Engle, PL. Influences of mother's and father's income on children's nutritional status in Guatemala. Social Science & Medicine 1993; 37(11): 1303–12.CrossRefGoogle ScholarPubMed
3Huttly, SRA, Victora, CG, Barros, FC, Teixeira, AMB, Vaughn, PJ. The timing of nutritional status determination: implications for interventions and growth monitoring. European Journal of Clinical Nutrition 1991; 45: 85–95.Google ScholarPubMed
4Khin-Maung, U, Khin, M, Wai, NN, Hman, NW, Myint, TT, Butler, T. Risk factors for the development of persistent diarrhoea and malnutrition in Burmese children. International Journal of Epidemiology 1992; 21(5): 1021–9.CrossRefGoogle Scholar
5Pryer, JA. Socio-economic and environmental aspects of undernutrition and ill-health in an urban slum in Bangladesh. PhD thesis, University of London, London, 1990.Google Scholar
6Doan, RM, Bishatarat, L. Female autonomy and child nutritional status: the extended family residential unit in Aman. Social Science & Medicine 1990; 31(7): 783–9.CrossRefGoogle Scholar
7Lima, M, Figuira, MD, Ebrahim, GJ. Malnutrition among children of adolescent mothers in a squatter community of Redclife, Brazil. Journal of Tropical Paediatrics 1990; 36: 14–9.CrossRefGoogle Scholar
8Ricca, JA, Becker, S. Risk factors for wasting and stunting among children in Metro Cebu, Philippines. American Journal of Clinical Nutrition 1996; 63: 966–75.CrossRefGoogle Scholar
9Thaver, IH, Ebrahim, GJ, Richardson, R. Infant mortality and undernutrition in the squatter settlements of Karachi. Journal of Tropical Paediatrics 1990; 36: 135–40.Google Scholar
10Islam, MA, Rahman, MM, Mahalanabis, D. Maternal and socio-economic factors and the risk of a severe malnutrition in a child: a case–control study. European Journal of Clinical Nutrition 1994; 48: 416–24.Google Scholar
11Engle, PL. Maternal work and child care strategies in peri-urban Guatemala: nutritional effects. Child Development 1991; 62(5): 954–65.Google Scholar
12Jongpiputvanich, S, Poomsuwan, P, Phittayanon, P. Prevalence and risk factors of protein energy malnutrition (PEM) in pre-school children of Klong-Toey slum, Bankok, Thailand. Journal of the Medical Association of Thailand 1992; 75(1): 39–44.Google Scholar
13Shekar, M, Habicht, JP, Latham, MC. Is positive deviance in growth simply the converse of negative deviance? Food and Nutrition Bulletin 1991; 13(1): 7–11.Google Scholar
14Government of Bangladesh. Report of the Task Forces on Bangladesh Development Strategies for the 1990s. vol. 3. Developing the Infrastructure. Dhaka: Government of Bangladesh, 1992.Google Scholar
15World Bank. Entering the 21st Century. World Development Report, 1999/2000. Oxford; Oxford University Press, 1999.Google Scholar
16Islam, N, ed. Addressing the Urban Poverty Agenda in Bangladesh. Dhaka: Asian Development Bank/University Press Ltd, 1997.Google Scholar
17Pryer, JA. Investing in children's nutritional status. In: Pryer, JA, ed. Poverty and Vulnerability in Dhaka Slums: The Urban Livelihood Study. Aldershot, UK: Ashgate, 2003.Google Scholar
18Food and Agriculture Organization (FAO)/World Health Organization (WHO). International Conference on Nutrition (Final Report 1992); Rome: FAO/WHO, 1992; 9–55.Google Scholar
19Rahman, M, Roy, SK, Ali, M, Mitra, AK, Alam, AN, Akbar, MS. Maternal nutritional status as a determinant of child health. Journal of Tropical Paediatrics 1993; 39(2): 86–8.CrossRefGoogle ScholarPubMed
20Mozumber, AB, Barkat, EK, Kane, TT, Levein, A, Ahmed, S. The effects of birth interval on malnutrition in Bangladeshi infants and young children. Journal of Biosocial Science 2000; 32(3): 289–300.CrossRefGoogle Scholar
21Alam, N. Birth spacing and infant and early childhood mortality in a high fertility area of Bangladesh: age dependent and interactive effects. Journal of Biosocial Science 1995; 27(4): 393–404.Google Scholar
22Rogers, BL. The implications of female household headship for food consumption and nutritional status in the Dominican Republic. World Development 1996; 24(1): 113–28.CrossRefGoogle Scholar
23Johnson, FC, Rogers, BL. Children's nutritional status in female headed households in Dominican Republic. Social Science & Medicine 1993; 37(11): 1293–301.CrossRefGoogle ScholarPubMed